Finding expert help early can help prevent inadequate treatment, frustration, stress, and wasted effort. Keep in mind that even after you locate an expert, that doesn't mean you'll be pain free. Even the best endometriosis doctors struggle with the treatment of endometriosis. The treatment goals for endometriosis may be to:
The choice of preferred treatment depends on your age, the severity of your symptoms, where the endometrial tissue is growing, how large the growths are, and your desire for pregnancy. Several factors and patient-specific indications / contraindications need to be thoroughly discussed and considered prior to treatment selection. Feel free to talk to your doctor about the advantages and disadvantages as well as the risks and benefits of different treatment options before making a choice. The choice of treatment will depend on several factors such as:
Medical treatments and/or surgery usually help patients manage or ease symptoms of endometriosis. However, the disease often comes back, despite good treatment. Remember, if one therapy does not work, another can be tried.
Hormone replacement therapy
Many types of hormones that can be prescribed by your doctor to slow the growth of endometriosis and may be given up to 6 months at a time. This type of treatment may prevent pregnancy after the first month of treatment. It should be noted that women with a history of endometriosis that take hormone replacement therapy (HRT) during menopause may reactivate the condition.
If a patient with endometriosis still cannot get pregnant after other types of treatment have been tried, she may consider other options. These may include a form of assisted reproduction, such as in vitro fertilization (IVF), or adoption.
Drugs can also be given for pain relief. These may or may not require a prescription. It is important that you ask about all of the side effects of any endometriosis medication. For example, medication that simulates menopause can cause bones to weaken. So be sure to consider the long-term effects of any medications.
Birth control - Birth control hormones, in the form of pills, the birth control injection called Depo-Provera, a skin patch or a vaginal ring are one of the most widely used treatments for endometriosis.
Danazol - This drug lowers a woman's estrogen levels and increases testosterone levels. Ninety percent of women report that the medication relieves their symptoms, though it does not cure the disease. It stops a woman's menstrual period and the pain that accompanies it, and puts her body in a state similar to menopause. In some cases, danazol also helps decrease pain during sex and bowel movements. Symptoms usually return shortly after women stop taking the medication
GnRH analogs - GnRH is a hormone that regulates a woman's menstrual cycle and cause a woman to stop having her period and produce a state that is similar, but not identical, to menopause. In some cases, the doctor may also prescribe estrogen to help deal with these symptoms. The drugs are usually effective for treating period pain and pain during sex.
Over-the-counter drugs - Tylenol, Advil, Nupren, Midol 200 and Medipren are usually the first line of treatment in controlling pain. They are inexpensive and non-addictive. These may be helpful for many women with endometriosis.
Progestins - These hormones are prescribed and used to shrink endometrial tissue. Progestin treatment usually stops a woman from ovulating each month.
Treatment via surgery can usually relieve symptoms of pain, but symptoms of endometrial growth may return. Your doctor may have to decide what type of procedure is best during the surgery iteself. Sometimes what is observed during surgery may be very different from what was expected. If surgery is needed, talk with your doctor before the operation. Be sure that you understand fully what is involved.
Symptoms of endometriosis almost always disappear for good during menopause or if the ovaries are removed. Surgery may also be performed to remove endometrial tissue and the scarred tissue that is located around it. In some cases you may need to have your uterus removed (a hysterectomy). Surgery will usually relieve symptoms and stop the production of hormones that cause further growth of endometriosis. The ovaries and the fallopian tubes may also need to be removed, but when possible, healthy ovaries and tubes are left intact to increase the chances of pregnancy later.
Menopause usually brings an end to mild-to-moderate endometriosis. However, women today are finding that many more options exist to help them fight the debilitating symptoms of endometriosis. Additionally, as public awareness has been focused on this disease, research centers devoted to the study of endometriosis have been established at major universities.